You are here

  • Home
  • Online First
  • Baseline concussion assessment performance by sex in military service academy rugby players: findings from the CARE Consortium

Article Text

Article menu
Download PDFPDF
Original research
Baseline concussion assessment performance by sex in military service academy rugby players: findings from the CARE Consortium
  1. Katherine J Hunzinger1,2,
  2. K L Cameron3,
  3. M H Roach4,5,
  4. J C Jackson6,
  5. G T McGinty6,
  6. J B Robb7,
  7. A J Susmarski8,
  8. C A Estevez9,
  9. S P Broglio10,
  10. T W McAllister11,
  11. M McCrea12,
  12. P F Pasquina13 and
  13. T A Buckley14,15
  1. 1Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  2. 2Penn Injury Science Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  3. 3Keller Army Community Hospital, West Point, New York, USA
  4. 4DoD-VA Extremity Trauma and Amputation Center of Excellence, Research & Surveillance Division, Fort Bragg, North Carolina, USA
  5. 5Clinical Investigation, Womack Army Medical Center, Fort Bragg, North Carolina, USA
  6. 6United States Air Force Academy, USAF Academy, Colorado, USA
  7. 710th Medical Group, United States Air Force Academy, USAF Academy, Colorado, USA
  8. 8Orthopedic Sports Medicine, United States Naval Academy, Annapolis, Maryland, USA
  9. 9Physical Therapy, United States Coast Guard Academy, New London, Connecticut, USA
  10. 10Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA
  11. 11Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
  12. 12Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  13. 13Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
  14. 14Kinesiology & Applied Physiology, University of Delaware, Newark, Delaware, USA
  15. 15Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
  1. Correspondence to Dr Katherine J Hunzinger, Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA; Katherine.Hunzinger{at}Pennmedicine.upenn.edu

Abstract

Background Normative student-athlete concussion assessment data may not be appropriate for service academy members (SAMs), particularly rugby players, because of the uniqueness of their academic/military training environment. Having accurate baseline data for this population is important because of their high risk for concussion and frequent lack of assigned sports medicine professional. The primary purpose of this study was to characterise baseline performance on a concussion assessment battery, with secondary purpose to determine effect of sex and concussion history on these measures among SAM rugby players.

Methods 601 rugby-playing SAMs (19.3±1.5 years, 37.9% female) completed baseline concussion assessments: the Sport Concussion Assessment Tool (SCAT) Symptom and Symptom Severity Checklist, Standard Assessment of Concussion (SAC) and a neuropsychological test (either ImPACT (Immediate Post Concussion Assessment and Cognitive Testing) or ANAM (Automated Neuropsychological Assessment Metrics)). Groups were compared using an independent samples t-test or Mann-Whitney U test. A 2 (sex) × 2 (concussion history) ANOVA was conducted to determine the effects of sex and concussion history on outcomes.

Results Women reported greater SCAT total symptoms (3.3 vs 2.8, p<0.001, r=0.143) and symptom severities (5.7 vs 4.3, p<0.001, r=0.139), and performed worse on ImPACT Visual Memory (79.3 vs 82.6, p=0.002, r=0.144) than men. Women performed better than men on SAC (28.0 vs 27.7, p=0.03, r=0.088), ImPACT Reaction Time Composite (0.59 vs 0.61, p=0.04, r=0.092) and ANAM Code Substitution Delayed (64.3 vs 61.5, p=0.04, d=0.433). Individuals with a history of concussion reported lower ImPACT Symptom Severity (2.6 vs 4.2, p=0.02, r=0.110). There was no interaction between concussion history and sex on outcomes.

Conclusions These findings provide reference data for SAM rugby players on baseline assessments and to help in clinical decision-making when managing sports-related concussion in absence of baseline data.

  • sports medicine
  • neurology
  • neurological injury

Data availability statement

No data are available. Data will be shared via requests to the lead author, KJH, pending approval by the NCAA-DoD CARE Consortium data core approval.

https://doi.org/10.1136/military-2023-002358

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    No data are available. Data will be shared via requests to the lead author, KJH, pending approval by the NCAA-DoD CARE Consortium data core approval.

    View Full Text

    Footnotes

    • Twitter @HunzingerUD, @ConcussionUD

    • Contributors KJH: research idea, data cleaning, data analysis including statistical analysis, data interpretation, manuscript (first draft), manuscript editing, and overall guarantor of manuscript. KC: study concept, study data collection, manuscript editing, facilitating funding. MHR: data collection, manuscript editing, data interpretation. JCJ: study data collection, manuscript editing. GTMG: study data collection, manuscript editing. JBR: study data collection, manuscript editing. AJS: study data collection, manuscript editing. CAE: study data collection, manuscript editing. SB: study concept, study planning, study funding, facilitating funding, manuscript editing. TWMA: study concept, study planning, study funding, facilitating funding, manuscript editing. MMC: study concept, study planning, study funding, facilitating funding, manuscript editing. PFP: study concept, study planning, study funding, facilitating funding, manuscript editing. TAB: research idea, data interpretation, data collection, manuscript editing.

    • Funding This study was funded by U.S. Department of Defense (W81XWH-21-1-0590, W81XWH1420151), National Institute of Neurological Disorders and Stroke (T32 NS043126).

    • Disclaimer Opinions, interpretations, conclusions and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense. In addition, the views expressed herein are those of the authors and do not necessarily reflect the official policy of the Department of the Army, Department of Defense or the US Government.

    • Competing interests KJH is an independent contractor with USA Rugby as a World Rugby Educator for the Strength and Conditioning and Referee Strands, yet neither entity was involved in the conception, design, analysis or interpretation of this study. All other authors report no potential conflicts of interest.

    • Provenance and peer review Not commissioned; externally peer reviewed.